Adapting Fit Testing for Those with Altered Senses: A Crucial Workplace Safety Concern

Losing the olfactory sense of taste or smell can indeed present challenges when conducting respirator fit testing, particularly if you are using qualitative fit testing methods that rely on the wearer's ability to detect test agents by taste or smell. While it is a relatively rare condition, anosmia (the loss of the sense of smell) or ageusia (the loss of the sense of taste) can occur due to various factors, including medical conditions, medications, aging and has been widely reported as a symptom of COVID-19. Here are some concerns and considerations when fit testing individuals with these conditions:

1. Ineffectiveness of Qualitative Fit Testing: Qualitative (QLFT) fit testing methods, using Bitrex® or Saccharin Solution, may be ineffective for individual with loss of the sense of taste. These individuals cannot rely on their sense of taste to detect the test agent, which will lead to inaccurate fit test results. Loss of the sense of taste can persist for an extended period, and relying on these methods would lead to inaccurate fit test results.
2. Alternative Fit Testing Methods: In cases where individuals have lost their sense of taste or smell, it is required to use alternative fit testing methods in order to use a respiratory protective device when participating in an OSHA Respiratory Protection Program for example. The Quantitative (QNFT) fit testing method, relies on specialized equipment to measure particle concentrations inside and outside the respirator, are a viable option as it does not depend on the wearer's olfactory sense of taste or smell.
3. Regular Medical Assessment: It is important for individuals with loss of olfactory sense of taste or smell to undergo regular medical assessments and provide accurate information about their condition to their employers. This information can help employers make informed decisions about the most appropriate fit testing method and respirator selection.
4. Adjustment and Comfort: Even if an individual cannot taste or smell the test agent, they should still be assessed for comfort and fit. This includes evaluating factors such as the respirator's seal and overall comfort during wear. If there are issues, adjustments should be made to ensure a good fit.
5. Documentation and Record-Keeping: Employers should maintain clear records of fit testing results, including any information about individuals with loss of olfactory sense of taste or smell. This documentation can serve as a reference point for future fit testing and respirator selection.

In conclusion, while the loss of olfactory sense of taste or smell can pose challenges during respirator fit testing, there are alternative methods like quantitative (QNFT) fit testing and considerations that employers can employ to ensure the safety and protection of workers in such cases. The key is to prioritize accurate fit testing and to adapt to the specific needs and conditions of each individual while maintaining a commitment to workplace safety.

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